A study, published on bmj.com , reveals that 1 in 3 older individuals who find it hard to read and understand basic health related information, may have an increased mortality risk, compared to those with stronger literacy skills.

Because of the increasing levels of long term conditions, as well as the UK government plans for patients to become responsible and active partners in their care, means that the study results have significant implications.

Already a large range of adverse health outcomes have been linked to poor literacy skills. The majority of studies researching health literacy (being able to apply basic knowledge and reading skills in a health context) have been carried out in the United States.

Low health literacy is connected with:

  • Higher rates of hospitalizations
  • Less knowledge of chronic diseases
  • Restricted use of preventive services
  • poorer physical and mental health

In England, however, the scale of literacy problems in older individuals is unknown.

Therefore, a study was conducted by researchers at University College London, in order to examine the association between mortality in older adults in England and health literacy, irrespective of known risk factors, such as pre-existing illness, age, and socioeconomic position.

7,857 adults, aged 52 and over, who participated in the second wave (2004-2005) of the English Longitudinal Study of Aging (ELSA), were enrolled to participant in the study. A test of functional health literacy was given to each participant, in order to evaluate how much they understood written instructions for taking an aspirin tablet. The researchers monitored deaths until October 2009.

During follow up, the researchers found that 321 (6%) of participants who scored high on the test died, 143 (9%) participants in the medium score group, as well as 157 (16%) in the low score group – a total of 621 deaths.

In addition, results showed that 1 in 3 participants was not able to fully understand the instructions on the medicine label, suggesting limited health literacy.

The team found that participants who scored lowest on the test were over two times more likely to die within 5 years, compared to participants with the highest scores. Age, general health and socioeconomic position differences at baseline accounted for not even half of the increased mortality risk.

Low health literacy was still a considerable predictor of mortality, even after the team adjusted for measures of cognitive (mental) function.

According to the researchers, results from the study indicate that a third of older individuals in England find it hard to understand and read basic health related written information. Older individuals with the poorest understanding have the greatest risk of mortality.

The researchers conclude that these findings should prompt healthcare professionals to use effective communication methods for patients with low health literacy.

They say:

Written by Grace Rattue